Study says defibrillator drones could save countless lives before ambulance eventually arrives. Seems obvious, but what happened to good-old CPR?

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The News:

 The speed of unmanned aerial systems, commonly called drones, could save lives, since for every minute that passes between cardiac arrest and CPR or defibrillation, the chance of survival drops by 10%.

Drones are already employed for anything from military to recreational use, from oil exploration to filmmaking, but they could also help save the lives of people who have suffered a cardiac arrest, research suggests.

A simulated study found that drones carrying a defibrillator, which could be used by a member of the public, arrived 16 minutes quicker than the emergency services on average, saving precious time, says The Guardian.

Jacob Hollenberg, director of the center for resuscitation science at the Karolinska Institute, Stockholm, who led the study, told The Guardian: “Cardiac arrest is one of the major killers in the western world. Every minute is crucial; I would say every second is crucial. Every minute that passes from collapse to [cardiopulmonary resuscitation] or defibrillation, the chances of survival goes down by 10%. That’s why survival after 10 to 12 minutes is basically zero. There’s a huge difference in using the defibrillator within the first few minutes. Even if you improve the timing of the ambulances in these type of situations, it’s too late–only one in 10 victims survive.”

The 5.7kg (12.5lb) drone was developed by the Swedish Transportation Agency to carry a 763g (1.6lb) automated external defibrillator (AED). The eight-rotor unmanned aerial drone, with a maximum cruising speed of 75km/h (47mph), was housed at a fire station north of Stockholm.

Over a 72-hour period in October last year, it was dispatched 18 times by two licensed pilots using GPS coordinates to out-of-sight locations where cardiac arrests within a 10km radius from the fire station had occurred between 2006 and 2014.

The results, published in the Journal of the American Medical Association, found that the median time from call to dispatch of the emergency services ambulance was 3mins, 0secs, compared with 3secs for the drone. The median time from dispatch to arrival of the drone was 5mins, 21secs, compared with 22mins,0secs for the emergency services.

The drone arrived more quickly than the emergency services in all cases with a median reduction in response time of 16mins, 39secs over a median flight distance of about two miles.

Limitations of the latest study included the small number of flights over short distances in good weather and the possibility of changes in traffic patterns from the period between 2006 and 2014 to the present day.

Additionally, the outcomes between those who receive resuscitation from the emergency services and from a bystander using an AED were not compared by the study, although Hollenberg says the defibrillators are “easier to use than a fire extinguisher.”

Hollenberg hopes that drone carrying defibrillators could begin operating in Sweden for real in one to two years. An additional, larger-scale trial will be carried out, and agreement needs to be reached with the aviation authorities.

Currently, laws in Sweden, as in the UK, require drones to be operated within sight. Hollenberg says future trials could look at use of drones for other health emergencies, such as allergic reactions and road traffic accidents.

Steve’s Take:

Drones aren’t just good for getting your Amazon and other online shopping in an instant. By carrying defibrillators, they could prove to be life-saving if your heart stops beating while you’re standing in line at the post office or dropping off your dry cleaning. That’s more like a personal paramedic, with wings!

As the above news item points out so clearly, only around one in ten people survives a cardiac arrest outside hospital. Having a bystander perform chest compressions improves your chances, but a shock from a defibrillator must be applied quickly to restart the heart.

Every minute without CPR and defibrillation reduces someone’s chance of survival by 10%. Defibrillators are designed to give spoken instructions so that anyone can use them, and many are available in public places, says New Scientist.

Bottom Line:

If anything seems more obvious than the use of drones to deliver an automated external defibrillator where a person has had an out-of-hospital cardiac arrest (OHCA)–saving on average 16 minutes compared with a 911-dispatched ambulance–I don’t know what is. Especially with such low survival (8%-10%).

Reducing time to defibrillation is unquestionably the most important factor for increasing survival in such cases. And there are lots. Recent estimates suggest that approximately 395,000 cases of OHCA occur in the US every year among patients of all ages, in which only 5.5% of all patients survive to hospital discharge (Daya et al., 2015a).

Here’s what I don’t get, though. What happened to good-old CPR? Especially here in the US. Was it the mouth-to-mouth issue with a complete stranger?

Steve's Take: #Defibrillator #drones are nice, but why not make getting a driver’s license contingent upon taking and passing a #CPR course? Click To Tweet

Adrian Boyle of the Royal College of Emergency Medicine, London, says the drone approach is interesting, but making sure more people can do CPR would probably have more benefit.

“One of the things we are bad at in the UK is teaching bystanders CPR, which would arguably be a much lower tech, more useful intervention than this,” said Boyle.

Stockholm, London and other cities have tested mobile apps that alert CPR-trained people if someone has a cardiac arrest nearby.

Hollenberg’s team has also tested using drones to search for people who are drowning.

“I’m convinced that the possibility of using drones in medical emergencies is enormous,” he says.

England’s National Health Service (NHS) is planning to use drones to assist hazardous area response teams, who deal with medical emergencies involving chemical, biological or nuclear materials. It is also looking at the possibility of using drone technologies to deliver blood and organs for transplant, says Christian Cooper of the National Ambulance Resilience Unit.

The adoption of defib drones is a solid idea as the world’s population ages. In 2015, 8.5% of people worldwide (617 million) were aged 65 and over. According to a recent report, this percentage is projected to jump to nearly 17% of the world’s population by 2050 (1.6 billion).

Yes, drones can make huge sense in a sparsely populated scenario for OHCA. But why not make getting a driver’s license contingent upon taking and passing a CPR course? Trust me, with all of us millions of boomers walking around, there aren’t enough drones ever going to be available to reach us in time as we drop to the ground whilst purveying the latest offerings at the local BevMo.

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